Dorji Tandin, Yangchen Pemba, Dorji Chencho, Nidup Tshering, Zam Kinley
Health Care and Diagnostic Division, Department of Medical Services, Ministry of Health, Royal Government of Bhutan, Thimphu, Bhutan.
Diabetes Prevention and Care Programme, Health Care and Diagnostic Division, Department of Medical Services, Ministry of Health, Royal Government of Bhutan, Thimphu, Bhutan.
WHO South East Asia J Public Health. 2016 Apr;5(1):44-47. doi: 10.4103/2224-3151.206552.
Bhutan has been witnessing a trend of increasing diabetes in recent years. The increase is attributed to a rise in risk factors such as overweight, high blood pressure, unhealthy diet and sedentary lifestyle among the population. To address the rising burden, the health-services response has been to establish diabetes clinics in all hospitals and grade one basic health units. People visiting the health centres who have high risk factors and symptoms for diabetes are screened using the World Health Organization cut-off level for blood glucose. They are then classified into prediabetes and diabetes. Accordingly, diet, medicine and physical activity are recommended as per their body mass index. To improve prevention and control of noncommunicable diseases, which include diabetes, the country piloted the WHO Package of Essential Noncommunicable (PEN) disease interventions for primary health care in low-resource settings in 2009, to promote early screening, treatment and follow-up, and adopted it in 2013. The WHO PEN has now been successfully integrated into the primary health-care system nationwide. It is planned that diabetes clinics will be upgraded to NCD clinics.
近年来，不丹的糖尿病发病率呈上升趋势。这种增长归因于超重、高血压、不健康饮食和久坐不动的生活方式等风险因素在该国人口中的增加。为应对日益加重的负担，卫生服务部门采取的措施是在所有医院和一级基层卫生单位设立糖尿病诊所。前往健康中心就诊且有糖尿病高危因素和症状的人群，会按照世界卫生组织的血糖临界值进行筛查。然后将他们分为糖尿病前期和糖尿病患者。据此，根据他们的体重指数推荐饮食、药物和体育活动。为加强包括糖尿病在内的非传染性疾病的预防和控制，该国于2009年在资源匮乏地区试点了世界卫生组织针对初级卫生保健的基本非传染性疾病综合干预包，以促进早期筛查、治疗和随访，并于2013年采用了该干预包。世界卫生组织的基本非传染性疾病综合干预包现已成功纳入全国初级卫生保健系统。计划将糖尿病诊所升级为非传染性疾病诊所。
